Are BP readings taken after a patient-physician encounter in a real-world clinic scenario the lowest of all the readings in a clinic visit

To determine the difference in Blood Pressure [BP] readings taken before, during and after the clinic encounter. Descriptive study. Cardiology Clinic, The Aga Khan University Hospital, Karachi, from January to August 2013. Hypertensive and normotensive participants aged >/= 18 years were recruited. Pre-clinic BP was measured by a nurse and in-clinic BP by a physician. After 15 minutes, two post-clinic BP readings were taken at 1 minute interval. All readings were taken using Omron HEM7221-E. Out of 180 participants, males were 57% and 130 [71%] were hypertensive. Mean SBP [Systolic BP] taken preclinic, in-clinic, post-clinic 1 and post-clinic 2 were: 126 +/- 20 mmHg, 131 +/- 23 mmHg, 126 +/- 20 mmHg and 121 +/- 21 mmHg respectively [p < 0.001]. Mean DBP [Diastolic BP] taken pre-clinic, in-clinic, post-clinic 1 and post-clinic 2 were 77 +/- 12 mmHg, 81 +/- 13 mmHg, 79 +/- 12 mmHg and 79 +/- 11 mmHg respectively [p < 0.001]. BP taken in the post-clinic setting may significantly be the lowest reading in a clinic encounter, making in-clinic BP unreliable to diagnose or manage hypertension